Journal : vol 6 : July/August: The scientific basis for alternative medicine

Systematic review of systematic reviews of acupuncture published 1996-2005

CJ Derry, Student
S Derry MA, Senior Research Associate
HJ McQuay DM FRCA FRCP(Edin), Professor of Pain Relief
RA Moore DSc FRSC, Director of Research
Pain Research and Nuffield Department of Anaesthetics, The Churchill, Oxford

Clin Med 2006;6:381-6

Abstract

Systematic reviews of acupuncture have tended to support its use, but few applied rigorous inclusion criteria. We tested the credibility of conclusions of systematic reviews of acupuncture published since 1996 by applying rigorous inclusion criteria. Reinterpretation used randomised and double blind trials with valid outcomes or design, and with information available from at least four trials or from 200 patients. Qualified support for acupuncture was originally reported in 12 out of 35 systematic reviews, and strong support was found in another six. Applying stricter inclusion criteria, however, showed that none of the 35 reviews supported acupuncture, predominantly because there were too few patients in the randomised, double blind studies. Six reviews with more than 200 patients in randomised, double blind studies had good evidence of no benefit. Systematic reviews of acupuncture have overstated effectiveness by including studies likely to be biased. They provide no robust evidence that acupuncture works for any indication.

Key points

• Systematic reviews have tended to support the use of acupuncture
• They have tended to use trials with known sources of bias
• Excluding trials with known sources of bias, no systematic review had evidence of efficacy
• There is no robust evidence from systematic reviews that acupuncture works in any indication

Key words

• acupuncture
• bias
• systematic review

This page last updated on September 1, 2006